Idiopathic Toe-Walking Gait in Children

Idiopathic toe-walking (ITW) in children is commonly linked to ankle equinus or a deformity which limits motion in the ankle joint during the contact phase of the gait cycle.

Williams et al. sought to measure the foot and ankle range of motion using weightbearing lunge tests and the six-item version of the Foot Posture Index (FPI-6).

30 children with a long-term history of habitual toe-walking between the ages of 4 and 8 years were age-matched with a non-toe-walking cohort.

The weightbearing lunge test aimed to determine the muscle flexibility of the gastrocnemius and soleus muscles by using a digital inclinometer positioned at the flat aspect of the Achilles tendon. This was performed in a bent-leg and straight-leg lunge position.

The FPI-6 was then calculated for each foot in a natural standing position, using the data sheet provided in the FPI-6 user manual.

A significant difference was established between the cohorts during the weightbearing lunge test. The results of the lunge tests were as follows: straight-leg (F58 =105.30, P < .001) and bent-leg (F58 = 84.91, P < .001).

There was not a significant difference between the cohorts in the results obtained using the FPI-6 measure. The FPI-6 value increased as the ankle range of motion reduced thereby determining that the straight-leg lunge test affected the FPI-6 value in the ITW cohort.

The study also found that the static foot posture of the toe-walking cohort was the same as their non-toe-walking peers.

While an ITW gait was observed to reduce flexibility at the ankle joint, the weightbearing foot posture of children in the ITW cohort as measured by the FPI-6 was found to be similar to that of their peers.

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